Inside Health

Senate Hits New Roadblocks on Health Care Bill

By ROBERT PEAR and DAVID M. HERSZENHORN

Published: December 12, 2009

Democratic leaders hit a rough patch Friday in their push for sweeping health care legislation, as they tried to fend off criticism of their proposals from a top Medicare official, Republicans and even members of their own party.

Slogging through a 12th day of debate on the legislation, the Senate found itself at an impasse over a proposal to allow imports of low-cost prescription drugs from Canada and other countries.

Democratic leaders tried to kill or neuter the proposal, offered by a senior Democrat, Senator Byron L. Dorgan of North Dakota.

The Medicare official, meanwhile, said that total national health spending would increase slightly as a result of the Senate bill, put together by the majority leader, Harry Reid, Democrat of Nevada. President Obama has repeatedly said that one of his top goals is to slow the growth of health costs.

Richard S. Foster, the chief actuary of the federal Centers for Medicare and Medicaid Services, said Friday that under Mr. Reid's bill national health spending from 2010 to 2019 would total $35.5 trillion. That is $234 billion, or 0.7 percent, more than the amount projected under current law, he added.

To help pay for coverage of the uninsured, the bill would impose new fees on health insurance companies and manufacturers of brand-name prescription drugs and medical devices. Mr. Foster said the fees would increase national health spending by $11 billion a year because the fees ''would generally be passed through to consumers in the form of higher drug and device prices and higher insurance premiums.''

Republicans said Mr. Foster's report confirmed what they had been saying for months.

''It is a remarkable report,'' said Senator Mike Johanns, Republican of Nebraska. ''It is a roundhouse blow to the Reid plan.''

Mr. Reid focused on other parts of the report that said the Senate bill would slow the growth of Medicare premiums and extend the life of the Medicare trust fund by nine years, so it would be exhausted in 2026, rather than 2017.

Centrist senators raised concerns about a major new element of the legislation, which would expand Medicare to cover some people ages 55 to 64.

''I just don't think it's a policy we should embrace,'' said Ms. Snowe, who discussed health care with President Obama in two private White House meetings in the last week.

The No. 2 Democrat in the Senate, Richard J. Durbin of Illinois, said Friday that he did not know details of the proposal put together by Mr. Reid in an effort to break an impasse over the legislation.

Senator John McCain, Republican of Arizona, said Republicans were exasperated because they did not know any details of Mr. Reid's proposal, which could affect one-sixth of the economy.

Responding to Mr. McCain on the Senate floor, Mr. Durbin said, ''I would say to the senator from Arizona that I am in the dark almost as much as he is, and I am in the leadership.''

''Most of us know the fundamentals, but we don't know the important details,'' Mr. Durbin added. He said the secrecy was frustrating to Democrats as well as to Republicans.

Senate Democrats are waiting for the Congressional Budget Office to complete a cost analysis of the legislation.

The No. 3 Democrat in the Senate, Charles E. Schumer of New York, said, ''It is very, very possible there will have to be some readjustment'' of the bill after the budget office finishes its work.

While Democrats appeared to be on the defensive Friday and Republicans were buoyant, the mood on Capitol Hill can shift quickly. Lawmakers said the health care debate would take many twists and turns before reaching a conclusion.

Senator Sheldon Whitehouse, Democrat of Rhode Island, said he was confident that Senate Democrats could muster the 60 votes they would need.

Mr. Schumer said: ''We're struggling to come together on the most difficult issue America has ever faced, and we're really getting close to the finish line. We've had our disagreements, but it has not been poisonous in any way.''

Senator Robert Menendez, Democrat of New Jersey, said: ''This debate is not about health care. This is an ideological battle driven by the right wing of the Republican Party.''

Senator Debbie Stabenow, Democrat of Michigan, said Republicans were stalling the health care bill because obstruction was a ''cash cow'' for their party.

''Their tactics fire up their base, who show their appreciation by writing checks -- lots of checks,'' Ms. Stabenow said in a fund-raising letter. ''The donations have been pouring in. And they are using those donations to distort the truth and attack Democratic senators who support the health insurance reform bill.''